Clinical pearlsThe effects of laparoscopic Nissen fundoplication to enhance pulmonary function in the treatment of a patient with severe asthma and gastroesophageal reflux disease
Section snippets
Case history
The patient is a 16-year-old male who has had a diagnosis of asthma most of his life and had been progressing to the point where he has had multiple hospitalizations over the last year for exacerbations and now has a nocturnal O2 requirement. His respiratory symptoms started at 1 month of life with wheezing, and he has been on inhaled bronchodilators since that time. He has also been on inhaled and oral steroids as needed. He has had a minimum of 2 to 3 hospitalizations/year since the first
Discussion
The relationship between GERD and respiratory disease in infants and children has been shown to be present in many forms. Infants often present with severe episodes of apnea and bradycardia, and reflux may play a role in sudden infant death syndrome. Reflux may also present as recurrent bouts of pneumonia or sinus infections and in some children can result in significant failure to thrive. However, the interaction between GERD and patients with corticosteroid-dependent asthma remains somewhat
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Cited by (12)
The effects of laparoscopic Nissen fundoplication on patients with severe gastroesophageal reflux disease and steroid-dependent asthma
2012, Journal of Pediatric SurgeryDiagnosis and definition of severe refractory asthma: An international consensus statement from the innovative medicine initiative (IMI)
2011, ThoraxCitation Excerpt :A correlation between gastro-oesophageal reflux and worsening of respiratory symptoms in patients with severe asthma has been convincingly shown54, but the benefits of antireflux therapy are disappointing.52 It has been suggested that, in this subset of patients, fundoplication may be efficacious.55 Asthma and obesity are frequently associated, but the contribution of obesity to ‘difficult-to-treat’ asthma and the mechanisms responsible for this relationship have not been fully clarified.
Laparoscopic Nissen Fundoplication: An Excellent Treatment of GERD-Related Respiratory Symptoms in Children - Results of a Multicentric Study
2018, Journal of Laparoendoscopic and Advanced Surgical TechniquesGastroesophageal reflux: Issues from a surgeon's perspective
2017, Esophageal and Gastric Disorders in Infancy and Childhood
Disclosure of potential conflict of interest: S. S. Rothenberg has consulting arrangements with Storz and Covidien. D. Bratton has declared that she has no conflict of interest.